<td width="100%">
<div style="width: 0px; height: 11px"><spacer type="block" height="11"></spacer></div>
<!-- text -->
<script type="text/javascript" language="JavaScript" src="/common/js/check_form.js"></script>

    <span class="zag">Изменение адреса доставки</span>
    <br><br>

            
<table border="0" cellspacing="10" cellpadding="0">
<form action="index.php" method="post" name="change" onsubmit="return(CheckMandatoryFields('change'));"></form>
      <tbody><tr>
        <td align="right" class="search" width="200">ФИО получателя:</td>
        <td><input style="width: 200px;" type="text" name="name" value= "{{address.name}}"></td>
      </tr>
      <tr>
        <td align="right" class="search" width="200">Телефон <font color="red">*</font>:</td>
        <td><input style="width: 200px;" type="text" name="phone" value="{{address.phone}}"></td>
      </tr>
      <tr>
        <td align="right" class="search" width="200">Факс:</td>
        <td><input style="width: 200px;" type="text" name="fax" value="{{address.fax}}"></td>
      </tr>
      <tr>
        <td align="right" class="search" width="200">Адрес <font color="red">*</font>:</td>
        <td><textarea style="width: 200px;" rows="5" cols="40" name="address">{{address.address}}</textarea></td>
      </tr>
      <tr>
        <td align="right" class="search" width="200">Примечание:</td>
        <td><textarea style="width: 200px;" rows="5" cols="40" name="note">{{address.note}}</textarea></td>
      </tr>
      <tr>
        <td align="center">&nbsp;</td>
        <td><input type="hidden" name="DELIVERY_ADDRESS_ID23" value="">
            <input type="Image" src="/common/img/but/save.gif" width="85" height="21" border="0" alt="сохранить">
        </td>
      </tr>
    
    </tbody></table>
    
    <!-- /text -->
</td>